ATI RN
labor and delivery nclex questions Questions
Question 1 of 5
The onset of labor is multifactorial. These reasons include which of the following? Select all that apply.
Correct Answer: B
Rationale: In the context of labor and delivery, the correct answer is B) Increase in estrogen. Estrogen plays a crucial role in initiating labor by stimulating uterine contractions. As pregnancy progresses, estrogen levels rise, leading to an increase in uterine sensitivity to oxytocin and the development of oxytocin receptors. This hormone also contributes to cervical ripening and the softening of the cervix in preparation for childbirth. Option A) Increase in progesterone is incorrect because progesterone levels actually decrease as labor approaches. Progesterone maintains the uterine quiescence during pregnancy, and its decline allows for the onset of labor. Option C) Increase in human chorionic gonadotropin (hCG) is not directly involved in initiating labor. hCG is primarily responsible for supporting the corpus luteum in early pregnancy and stimulating the production of progesterone. Option D) Aging of placenta is not a factor in the onset of labor. While placental aging can impact fetal well-being, it does not directly trigger the initiation of labor. Understanding the hormonal changes that occur during pregnancy and their impact on the onset of labor is crucial for healthcare providers involved in maternity care. By recognizing the role of estrogen in labor initiation, practitioners can better support and manage the labor process for expectant mothers.
Question 2 of 5
The nurse has just performed a sterile vaginal examination on her patient and reports the examination as 4 cm, 50%, –1. What does this represent?
Correct Answer: D
Rationale: The correct answer is D) Dilation, effacement, and station. In labor and delivery, these three components are crucial assessments to monitor the progress of labor and the descent of the fetus through the birth canal. Dilation refers to the opening of the cervix measured in centimeters, effacement is the thinning of the cervix expressed in percentage, and station indicates the position of the presenting part of the fetus in relation to the ischial spines of the pelvis. Option A) Effacement, station, and dilation is incorrect as the order of the components is reversed. Option B) Dilation, station, and fetal lie is incorrect because fetal lie is not typically included in the assessment of vaginal examinations in labor. Option C) Dilation, effacement, and status of membranes is incorrect as it does not include the station, which is an essential aspect of assessing the descent of the fetus. Understanding these components is crucial for nurses and healthcare providers in labor and delivery settings to accurately assess the progress of labor, determine the need for interventions, and provide appropriate care to the mother and baby.
Question 3 of 5
On admission to the labor unit, a primigravid woman at 38 weeks gestation states, “I need to urinate more now but at least I can breathe easier.” The nurse is aware that this is likely due to which physiological process?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Lightening. Lightening refers to the descent of the fetal presenting part into the maternal pelvis as the fetus settles into a lower position. This physiological process relieves pressure on the diaphragm, allowing the woman to breathe more easily. Additionally, as the fetus descends, it shifts away from the bladder, decreasing pressure on it and leading to increased urinary frequency, which explains why the woman feels the need to urinate more. Regarding the incorrect options: A) Onset of labor typically involves contractions, cervical dilation, and effacement, but it does not directly relate to the changes in pressure on the bladder and diaphragm described in the scenario. B) Effacement is the thinning of the cervix in preparation for labor, and it does not influence the woman's ability to breathe easier or her urinary frequency. D) Rupture of membranes occurs when the amniotic sac breaks, leading to the release of amniotic fluid, but this event does not directly affect the woman's breathing or urinary patterns in the manner described in the question. Understanding these physiological changes in late pregnancy is crucial for nurses caring for women in labor and delivery, as it helps them recognize normal processes and provide appropriate support and education to expectant mothers during this critical time.
Question 4 of 5
A nurse performs a vaginal examination on her patient in early labor and determines that the head is ballotable. What is this defined as?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Floating. When the nurse determines that the head is ballotable during a vaginal examination in early labor, it means that the presenting part of the fetus is freely movable and not yet engaged in the pelvis. This indicates that the fetus has not yet descended into the birth canal and is still in a high position, which is characteristic of early labor. Option B) Zero station refers to when the presenting part is at the level of the ischial spines, indicating engagement in the pelvis, which is not the case in this scenario. Option C) +1 station and Option D) -2 station both indicate varying degrees of descent of the fetus into the birth canal, which contradicts the finding of the head being ballotable. Understanding these concepts is crucial for nurses and healthcare providers caring for laboring women as it helps in assessing the progress of labor, determining the stage of labor, and making informed decisions regarding the management of labor and delivery. Recognizing the significance of different fetal station levels and what they signify can guide clinical practice and ensure the safety and well-being of both the mother and the baby during childbirth.
Question 5 of 5
A fetus is positioned in the occiput anterior position. The nurse determines that the fetus is positioned in which way?
Correct Answer: B
Rationale: In labor and delivery, understanding fetal positioning is crucial for monitoring progress and ensuring a safe delivery. In the given scenario, the correct answer is B: "The fetal head is closest to the vaginal opening and the occiput is directed toward the maternal symphysis." This answer is correct because the occiput anterior position indicates that the baby's head is facing downward with the back of the head (occiput) toward the front of the mother's pelvis (maternal symphysis). This is the optimal position for a vaginal delivery as it allows for the smooth passage of the baby through the birth canal. Option A is incorrect because in the occiput anterior position, it is the fetal head, not the shoulder, that is closest to the vaginal opening. Option C is incorrect as it describes the occiput posterior position where the fetal head is closer to the uterine fundus, which is not the case in the given scenario. Option D is incorrect as it describes the occiput transverse position where the fetal head is directed towards the maternal sacrum, which is also not the position mentioned in the question. Understanding fetal positioning is essential for nurses and healthcare providers in labor and delivery settings to assess progress, anticipate potential complications, and provide appropriate care during childbirth. It ensures a positive birth experience for both the mother and the baby.